Bilingual Care Manager – Patient Support Call Center -Remote

Position Summary

The Care Manager is responsible for contacting insurance companies to obtain correct eligibility information, performing benefit investigations, copay assistance, and checking prior authorization and/or appeal status. The position involves direct contact with patients and/or providers to evaluate eligibility for assistance programs and adherence support. This is a remote position.

Responsibilities

• Perform outbound calls to obtain appropriate information and document accurately.
• Answer inbound calls and assist customers with pharmacy-related services.
• Maintain strict professionalism in all communication methods while providing efficient, courteous, and friendly service.
• Contact insurance companies for benefit investigation and coverage eligibility.
• Provide prior authorizations and appeals support.
• Absorb patients with the enrollment process for manufacturer and non-profit organization copay assistance programs.
• Update job knowledge by participating in educational opportunities and training activities.
• Work efficiently both individually and within a team to accomplish required tasks.
• Maintain and improve quality results by adhering to standards and guidelines by meeting quality standards set forth by program KPI's.
• Report ADE’s according to program policy and guidelines.
• Adhere to all HIPAA guidelines.
• May assist with onboarding new employees.

Required Qualifications

• High School Diploma or equivalent
• Minimum one year experience in medical billing, reimbursement, insurance verification, or similar related medical office experience.
• Bilingual (English & Spanish)
• Previous data entry experience (minimum three months) and ability to type 30wpm+
• Able to demonstrate high attention to detail in work.
• Able to demonstrate advanced ability/knowledge of all Microsoft Suite programs (Teams, Word, Excel, Outlook, etc.) and soft phone systems (WebEx, Mitel, Shoretel, etc.).
• Exceptional communication skills, both written and verbal.
• Able to work in a virtual team environment by being available and responsive during working hours.
• Excellent follow through

Preferred Qualifications

• Some College
• Previous experience in Patient Support Services (Hub).
• Previous Customer Service experience in the healthcare field.